1/6 Buzz--advice needed

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Sarah and Buzz

Sarah and Buzz

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Ok, so I just checked her again (I haven't tested any more since that # yesterday) and it's 285!! I am, indeed, saying WTF!

I used a bottle of strips that expires March of 2010 and I tested with the control solution, so I know it's not that. I tried to look in her mouth and it looks okay but I am not a tooth expert so...

My real dilemma is this: I can't just give a drop or 2 of PZI because I think my bottle has gone bad. It had floaties in it, swirling around the bottom. :( So I have the Lantus that I got for free for just such an occasion, but I really don't think you can just start giving a new insulin, right? I mean, I know people switch all the time and that's what they start doing but it just seems so....I don't know. I'm in a tizzy over here. ;)

So my questions are: absent of any symptoms that I can tell, do I take her to the vet and have them rule out an infection before I worry about giving insulin? Do I just give her some Lantus? If so, how much? Do I just wait it out for another 24 hours?

ETA: Hi Terri! Glad to see you here in PZI. :) How has life been treating you?
 
Well we don't like that number either. Have you posted in Health? I don't know what you should do. I hope you find an easy solution to this.
 
How's she acting Sarah? Any excessive PU/PD? Personally, I'd take her to the vet and get a blood test and urine test done to rule out infection. I

Have you been testing regularly or has it been awhile? If it's been awhile since your last test, I'd also have a fructosamine run. That will tell you if today is a fluke. But I'd probably wait until the chaos at home was over to make sure this isn't just stress.

As for the insulin, if it turns out not to be stress or another medical problem, you'll need to decide if you want to switch insulins to Lantus or ProZinc. You've got a couple of days to think it over.

(I'm doing fine.....only 2 more chemos to go. I am SO ready to have hair on my head again.)
 
Thanks, Ele and Terri, for the support! :)

Terri, the workers left yesterday so have been gone almost 24 hours. Buzz's numbers never really changed much at the vet vs at home, so it seems a little high for a stress spike but possible.

Definitely no PD and it doesn't seem like any PU either.
 
Terri

Terri, I just wanted to say Hi and tell you that I'm very glad you're back and that you're doing so well. My best wishes for the successful chemo finish and a full head of hair. I really hope you get back to normal quickly. We've missed you here.
 
Terri, I echo Ele: I am so glad you're back and almost done with chemotherapy. Winter is no time to not have hair! ;) We have indeed missed you. :D
 
Oh gosh Terri I had no idea you were going through chemo, I am so sorry to hear that! I helped a friend through that a couple years ago - it was tough on her, but we turned it into a good time with little "chemo parties". Hope you are hanging in there ok. That makes me extra super mad with others' meanness in that doggone TT thread - I tried to compose a post today but just couldn't figure out what I wanted to say or how to say it, so I let it go. I was much happier when I just stopped visiting TT!!!!

Sarah, I have no idea what to suggest. What a bummer!!!! Hope others here or on Health can help you figure out what to do. As for the PZI, my only thought is maybe there is some way you can get some w/o having to invest in a new bottle? I don't know if it's safe to "share vials", but maybe there is someone near you, or someone in Supply Closet with something they could send you at not full price? I'd be scared to start up the Lantus too when it's oddball like this. In theory, she may end up just needing a shot or a few of PZI to get her back in good territory and then her pancreas will kick back in, but that's just speculation.
 
Sarah, after reading everyone's replies, I think you ought to at least get a u/a. If you collect the urine yourself (I know this is not recommended), it is usually under $40. As you know, Blackie's UTI's make his bgs go really high and he has no symptoms other than high bgs.
 
I think what I am going to do is give a microdose of PZI. Jen on Health pointed out that it can't do any harm, even if it is no longer good (which I strongly feel that it is not). If no improvement, I will take her in to the vet tomorrow.

Unfortunately, I have never had any luck getting urine for samples or for ketones from Buzz. She knows, I swear she does, and as soon as I leave, she goes. Or if she's locked in a room with a litterbox, she will hold out on me forEVER. I will most likely have to just suck it up and get a cystocentesis.

Ugh, I am really bummed to be in this position! It wouldn't bother me nearly as much if we still had PZI. I'm trying not to get all gloom and doom but I'm a worrier by nature. ;)
 
I'm not back permanently folks. I've just been stuck at home for a few days with a seriously awful case of peripheral neuropathy (can't feel one of my feet). Bored out of my mind. When I have to go into the office it takes all my energy so I nap most evenings until I get up enough energy to go to bed. Cats are so lucky that the methyl-B12 resolves their neuropathy!

But thanks for the welcome back greetings!
 
Terri,
So glad you are around, even if just temporarily--tho that is a bummer of a reason. Looking forward for you to have lots of hair and the energy to be back here regularly!

Sarah,
Is there a cost difference in ProZinc and Lantus? I know nothing of these insulins, but I have read here that the ProZinc is more flexible in terms of when you have to shoot. Does that matter to your schedule?
 
Judy- The only reason I got the Lantus is because it was free. I knew if I didn't end up using it, there would be someone here who could. I like what I have heard about ProZinc so far, albeit limited comments. At this point, sadly, it's basically a matter of having the insulin and not having to pay for it. I don't have $100 to drop on a bottle of ProZinc even if I wanted to, especially after what will surely be at least a $75 trip to the vet on Friday to see what's up with Buzz.

Unfortunately, I already shot the PZI tonight. I couldn't find anything online about it being dangerous to use, so I went ahead and did it. Now I'm second guessing my decision, but it's too late for that. It did nothing. At +4, her BG was 301, whereas it was 312 when we shot her.

I know this isn't the worst thing in the world by a long shot, but I am so frustrated! I knew it was a possibility that Buzz wouldn't stay OTJ forever, but it hasn't even been a month! My gut feeling is that there's an infection of some kind. There almost has to be, for her #s to shoot up so high in such a short amount of time. Paws crossed that it's something easy to treat and she won't even need insulin to get back on the wagon, as it were.

We have an appointment on Friday; our vet is out tomorrow. I don't know whether I should let her #s go for another 36 hours until the appointment or if I should try to figure out something with the Lantus for tomorrow. I think I will post over there and see what they think.

I'm sorry I've been so wrapped up in my own drama today that I haven't even asked how everyone else is doing! I hope you are all fine and warm and without the BG drama. It's snowing here and it's very pretty. We went to the grocery store today to stock up; they're calling for 5 inches by tomorrow afternoon! That's just what you do around here when there's snow in the forecast. ;) We went at about 2:00 this afternoon and I got the LAST half-gallon of milk. The very last one in any type (skim, 2%, etc) or brand. I also got the last loaf of whole wheat bread on the shelf. These people take their milk and bread seriously, y'all!
 
Sarah,
This is all so trial and error---no point in second guessing, there is just no way to know. And most important, there is no harm done. Glad you can enjoy the snow! I think you should listen to your gut--infection makes sense to me. Hope whatever it is does not last and Buzz is OTJ again soon.
 
Yeah, I don't know with Lantus how long it takes for the shed to build up. I don't think I'd be worried about shooting it literally if I were in your shoes, just more wondering if it's the right approach, since hopefully she will go right back to OTJ quickly. If Lantus takes a few days to build up, I'd want to go with faster acting, but I just don't know enough about Lantus to say.

Also you could go for that free sample vial of BCP PZI. Of course it probably takes a few days to ship, but at least it would be something on hand. Have you tried just shooting a larger dose of the PZI you have? I'm still unsure about floaties, but she may just need a bit more (not a lot, but I'm figuring you just gave her a drop? will check SS as soon as I get back to that page!).

ok, so I see you shot 0.1u. Yeah, I wouldn't conclude from that the PZI won't help. Still worried about floaties (ok, I've said it 5x now, will stop!!! :lol: ), but setting that aside, I'd try a bit higher dose, and at least 3 cycles before concluding it isn't helping. When Bix went high after his dental, I had to go back up to around 1u I think for a few days, and we've seen how much more Blackie needs with an infection.

Just trying to help you brainstorm, no criticism or anything, hope it doesn't sound that way. :-) And no dosing advice either, just sharing my experiences and POV. :lol:
 
did you try calling Idexx to ask if your PZI is safe to use? I don't see an 800# on my vial & I don't have the insert still, but seems like even if they aren't making it, they should still be able to answer questions... just a thought.... :)
 
Oh, that's a good thought about calling Idexx! And about getting the free sample of ProZinc. My vet is actually switching to that for what she prescribes, so I am wondering if perhaps she has some sample bottles or somesuch.

Dave (DHW) thinks that we should try more PZI (as in a greater dose) but I am firmly in the "it doesn't work" camp. Her BG was 247 24 hours after her insulin, so it's definitely still high, but lower than it was yesterday. I can't seem to find a definitive answer as to whether or not insulin with floaties is dangerous or not, so that makes me nervous. It's been 24 hours since we gave her the small dose, and nothing seems to be amiss.

It seems stupid to me now, thinking especially about Blackie's #s while he has an infection, that I didn't shoot more yesterday. I should have gone with at LEAST 0.5u. Well, at this point, her vet appointment is less than 24 hours away. I just looked up Idexx and I can't make heads or tails of their directory. I tried to find customer service and I called an 800 # but it said it was after hours. I'm not even sure if that's the right number.

Anyway, I completely agree with your sentiment re: Lantus and wondering if it's the right approach. I would rather err on the side of caution and have her be in higher numbers for a couple of days than do something wrong. We will continue to check her and if she goes back above 300 tonight, we will give her more PZI, despite my reservations.

Thanks for your thoughts; I didn't think at all that it was criticism. And so noted about the lack of dosing advice. ;)
 
The Lantus is not going to work right away the was PZI does. I hate to repeat myself from the other PZI comparison threads, but the fact that you can shoot PZI and expect an immediate response is a HUGE benefit IMHO. For example, Lucy's BGs shot up yesterday for some reason. She had a morning preshot of 120 but an evening preshot of 291. This morning her preshot was 312 and tonight it was 264. If her normal pattern follows, she will be back in the 100s by tomorrow night. With PZI she would have been back on track this morning, but Levemir, like Lantus, is slow acting.

Personally, Sarah, if I was in your shoes, I'd spend the $30 to buy a bottle of N rather than try switching to a new insulin. N is another insulin that gets a bad rap. If you use it correctly, it can be quite effective and it doesn't require a prescription (another benefit).
 
Terri and Lucy said:
The Lantus is not going to work right away the was PZI does. I hate to repeat myself from the other PZI comparison threads, but the fact that you can shoot PZI and expect an immediate response is a HUGE benefit IMHO. For example, Lucy's BGs shot up yesterday for some reason. She had a morning preshot of 120 but an evening preshot of 291. This morning her preshot was 312 and tonight it was 264. If her normal pattern follows, she will be back in the 100s by tomorrow night. With PZI she would have been back on track this morning, but Levemir, like Lantus, is slow acting.

Personally, Sarah, if I was in your shoes, I'd spend the $30 to buy a bottle of N rather than try switching to a new insulin. N is another insulin that gets a bad rap. If you use it correctly, it can be quite effective and it doesn't require a prescription (another benefit).
Click to expand...

I didn't know anything about N, and I sort of feel like I still don't, even after reading the Humulin N primer on the ISG. It sounds like it works very quickly, and that's what is good about it (IMO) but also scary. They talk about getting curves and knowing when your cat's nadir is because it can work so dramatically. I guess for the first time you give it and just test, test, test?

Just to make sure I understand you correctly, you would (in my situation) give N if there is no infection/cause for her higher BGs, rather than starting on Lantus? If there is an infection and we assume ABs will clear it up, would you still give N, or just wait for the BGs to come down once the infection clears?

I'm definitely open to this idea, it's just a bit scary for me, especially because I don't know anything about N. I'm going to go look up some more info on it and see if I can get a better handle on it. Thanks for the idea! :)
 
EDIT - Oops - I did not read about not having the dough for ProZinc. I'm so sorry.
If you find a way to be able to afford ProZinc, I would not worry. A 200 cat study can't be that far off. Our experience has been complicated by me giving H about 5 days of dry food prior to the switch to bring him back from circling the drain. And like you I think my old bottle was beginning to poop out. But we are zeroing back in on things - slowly the way I like.

With H I have not noted any observable buildup of PZI. Others have noted otherwise.

Some vets and most online pharms will price match.... from what I hear $90 is the fair price. Factually, it is what Valley Drug and Compounding in Encino sells it for & they could overnight it to you.
http://www.1pharmacy.com

From what I hear about insulin in animals [from a person who's done research in dogs], it does not necessarily matter what type [human, pork etc.] they get. And from what I interpret from this board it is more how the insulin is bound. PZI being one binding that dictates how this insulin is released. Lantus has it's own mechanism [something about Ph if I recall correctly]. I don't now about Lev. Anyway, if the given amount of insulin is released in a shorter amount of time then it might be expected to see a larger delta at a given PS.. maybe. BIG assumption. In other words, same bang in a shorter time period would have to have an effect somewhere [maybe delta?]

Why not move to Lantus if that is what you can afford right now?
 
Sarah and Buzz said:
It seems stupid to me now, thinking especially about Blackie's #s while he has an infection, that I didn't shoot more yesterday. I should have gone with at LEAST 0.5u.
Click to expand...

I think you did the right thing actually. Given the drop she had before on just a drop of insulin, and not knowing if she does have an infection or not, you don't really know what you are dealing with now and how she will react to the insulin. My 2c is you take a quicker version of SLGS - start at a tiny bit like you did (you could have seen a 50 nadir, right? she's done that before!!!). No action, so bump the next dose up a bit, to whatever feels safe - 0.2u or 0.4u, something in there. If you see 0 action again with that, or small to moderate action that doesn't improve in 2-3 cycles, then increase again.

ECID, and we know Buzz is special :) and loves the drama. So I wouldn't have started with 0.5u with her. When Bix went high with his dental I did raise things pretty fast, but I started with doses that had previously worked. When they didn't work, I didn't wait as long as I have in the past, I took quick action. But I did overshoot a couple times in my impatience - thankfully he was ok, but I think there were a couple points where I should have waited 2-3 cycles, instead of just bumping it up right away on a higher #.

Anyhow, long-winded way to say I think you did good, but maybe concluded too quickly that it wasn't working. :) I like the idea of N too. I know very little about it, but I have a relatively untested/unproven theory that when we already know their pancreases can do the job, mostly they just need to get popped back into the good zone so their pancreas can step back in and take over. And $30 isn't bad, and no prescription needed, didn't know that! If I were in a bind in a similar situation, I might consider too getting a vial of Vetsulin ($25 range), and try a tiny dose of that. Though I wasn't happy with it way back when, I love how it gets #s down quickly. Wish I had kept the vial I had actually, but I tossed it in disgust cuz I was SO grumpy at that point!!!
 
Sarah and Buzz said:
Just to make sure I understand you correctly, you would (in my situation) give N if there is no infection/cause for her higher BGs, rather than starting on Lantus? If there is an infection and we assume ABs will clear it up, would you still give N, or just wait for the BGs to come down once the infection clears?
Click to expand...

Sorry I wasn't clear Sarah. I was only suggesting the N as a stop gap measure, instead of the PZI with floaties or starting a new insulin when you don't know the cause of the high BGs. If she has come out of remission (i.e., the vet can find no cause for the high BGs), I would go with the Lantus.
 
Ok, thanks everyone! I feel better with a list of possible things to try. Vet appointment is in 1.5 hours so hopefully we will have some answers then. I'll post and let you know how it goes. I'm a little worried about Buzz turning into an icicle on the way there! I will definitely be warming up the car before I put her carrier in there. It is 13 degrees right now with a windchill of -2. Joanna, I'm coming to visit. And it sounds like I need to bring Ele and Sherri with me. ;) Terri, is it cold your way too?
 
Hope the vet trip goes well and they can figure out what is going on!

To comment on something you wrote, I'm not sure if #s will tend to "come down on their own" or not. My suspicion is that once they are high enough for long enough, the pancreas in a diabetic cat, remission or not, just can't do it. Personally, I would lean on the side of not waiting to find out, i.e. get out of the high #s as fast as you safely can, and just assume Mr. P needs some assistance. I don't know if that is correct or not, just my gut instinct on it.

If it's any consolation, it is sprinkling here :sad: and I'm pretty sure it's not even hitting 60 today. :cry: ..... :lol: j/k... I am very sympathetic, and grateful I escaped the nasty weather! Hope it improves for everyone soon.
 
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